North Carolina-based MJM Investigations Inc.’s Fraud Prosecution Team aided government authorities in the recent convictions of eight individuals for fraudulent workers’ compensation claims, totaling over $200,000 in savings to MJM’s clients.
Such was the case for Ron Mason, a deliveryman for a bottled water service in Tucson, Ariz. Mason alleged an injury to his right hand as the result of being frightened by a Gila monster (lizard) during a routine delivery.
Mason subsequently took time off of work for his injury for an extended period of time, and reportedly continued to receive workers’ compensation benefits based on his statements that he could not work and was not working. Surveillance was finally initiated and the investigator discovered Mason allegedly had been working for a carpet cleaning service for seven months and had received over $11,000 in temporary disability benefits.
The MJM Fraud Investigator assembled a prosecutorial package to aid the Arizona Department of Insurance and the Arizona Attorney General in the conviction of Mason. On March 5, 2003, the case was finally resolved in the Pima County, Arizona Superior Court when Mason was sentenced for one count of insurance fraud and ordered to pay back $11,735 in restitution to MJM’s client. Mason was also fined an additional $1,500 and sentenced to serve three years of probation.
In addition to investigating suspect claims, MJM (www.mjminc.com) compiles a prosecutorial package that aids government authorities in convicting individuals engaged in fraudulent activities. MJM developed a comprehensive anti-fraud and claim investigations program by integrating and coordinating claim investigations with fraud detection, investigation and criminal prosecution. MJM insures compliance with mandatory statutory and regulatory requirements to report suspected fraud through a comprehensive and strategic anti-fraud plan.
The MJM Fraud Prosecution Team has more than 100 years of combined insurance experience, assisting government authorities in over 700 criminal arrests and convictions for insurance fraud, and has aided in the recovery of more than $14,000,000 in criminal court ordered restitution.
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